人乳头瘤病毒感染与喉鳞状细胞癌发生及预后的关系

Correlation between human papillomavirus infection and the pathogenesis and prognosis of laryngeal squamous cell carcinoma

目的探讨人乳头瘤病毒(HPV)与喉鳞状细胞癌(LSCC)发生的关系以及HPV对LSCC患者预后的影响。方法回顾分析2004~2013年在本科就诊的252例LSCC患者的临床资料。所有手术标本为4μm厚切片,通过P16免疫组织化学染色及荧光定量聚合酶链反应(PCR)检测HPV的阳性率及分型。p16及HPV DNA同时阳性时认为HPV感染阳性。采用Kaplan-Meier法统计252例LSCC患者的总生存率及HPV阳性率对患者生存率的影响。结果 252例LSCC患者的P16阳性率为7.1%(18/252),HPV DNA的阳性率为6.0%(15/252),其中14例为HPV-16感染(93.3%),1例为HPV-18感染(6.7%)。252例LSCC患者的3年总生存率为67.0%,HPV DNA阳性患者的3年生存率为77.0%,HPV阴性患者的3年生存率为65.0%(P=0.25)。结论中国LSCC人群中HPV的阳性率较低。HPV感染与LSCC患者的预后无显著关系。

Objective To determine whether human papillomavirus （HPV） infection is related to the prevalence and prognosis of laryngeal squamous cell carcinoma（LSCC）. Methods A retrospective cohort study was applied on a total of 252 LSCC patients enrolled from 2004 to 2013. Paraffin-embedded tissues were cut as 4 μm slices. PI6 immunohistochemistry and fluorescence quantitation polymerase chain reaction （PCR） high risk HPV DNA tests were applied to detect the HPV infection status respectively in 252 specimens. Long-term survival rates were calculated using the Kaplan-Meier method. Results The p16 positive rate of all the patients was 7. 1% （18/252）. Six percent （15/252） of LSCC patients were HPV DNA positive. All the HPV DNA positive patients were p16 positive, 93.3% （14/15） of the HPV DNA positive patients were HPV type 16 and the rest was HPV type 18. The 3-year overall survival rates were 67.0% for all 252 patients, 77.0% for HPV DNA positive patients, 65.0% for HPV DNA negative patients （P =0.25 ）. Conclusions HPV has low prevalence in Chinese LSCC people. HPV infection status is associated with ISCC but may not be an available prognostic factor for [SCC. （Chin J Ophthalmol and Otorhinolaryngol,2017,17：170-175）